Good Medicine - Residency II
Copyright© 2025 by Michael Loucks
Chapter 7: An Interview
March 16, 1990, Circleville and McKinley, Ohio
"Did you get the students you wanted for Residency?" Kris asked when I arrived home on Friday evening.
"We did. We actually did fairly well, landing our top picks, including the one we suggested change her Match selection order. I think everyone is happy."
"Good! Are we still meeting the gang for Chinese food?" Kris inquired.
"Yes," I replied. "The consensus, according to Fran, is that we'll see The Hunt for Red October. I read the book, and I enjoyed it, even though I prefer science fiction to Tom Clancy's political thrillers."
"I've heard good reviews, and I'm OK with seeing it. We'll take Rachel to my parents' house. Oksana decided to stay home tonight."
"I'm not surprised, given she's towards the end of her eighth month. I can't imagine she'd be comfortable sitting in the theatre for two hours and fifteen minutes!"
"Not to mention at least two trips to the ladies'!"
"May I say I'm happy with the initial division of labor with regard to having children?" I asked with a goofy smile.
"Only if you want to sleep on the couch!" Kris exclaimed.
"An idle threat, and you know it! Let me get the Tsarina ready. Is the plan to pick her up tonight or tomorrow morning?"
"Tomorrow, on the way to band practice."
"And you're still planning to sing at both Proms?"
"Russian woman! Strong like ox!" Kris said gruffly, barely concealing a smirk.
I laughed, "If _I_ had said that, I'd be in serious trouble!"
"Yes, you would!"
"Papa!" Rachel exclaimed. "«Aller chez grand-mère?»" ("Go to grandma's?")
My sister-in-law had struck again!
"In a few minutes. Please put the toys you want in your backpack."
"OK!" she agreed.
About fifteen minutes later, Rachel was safely with her maternal grandparents, and Kris and I were on our way to the Chinese restaurant to meet our friends for dinner. When we arrived, Fran and Jason were just getting out of their car.
"Did Sophia Match with UC San Fran?" Fran asked.
"She did!" I replied. "She's ecstatic."
"I bet!" Fran declared as we walked towards the entrance to the restaurant. "That's an elite program, and they're doing truly groundbreaking work. How are you holding up?"
"I miss being in the ED, but I'm drinking from the firehose as a surgeon. I'm doing PGY3 work as a PGY1."
"Well, one good thing came out of that nightmare, then," Jason said. "How are your doctor friends doing?"
"Shelly Lindsay is going stir-crazy during her enforced break. She's back in two weeks. Loretta is making progress, but it's slow. Fran, you should go see her."
"You're right, of course," Fran agreed. "I'll arrange to go on Wednesday. Has her prognosis changed?"
"No. It's still 'wait and see'. My inexpert opinion is she'll walk with braces and a cane or one of those lower-arm crutches. I think she'll be able to handle working in the ED, but it's not up to me. It'll be up to Dutch Wernher, the new Chief of Emergency Medicine."
"Where's he from?" Fran asked as we walked in and moved towards our reserved tables.
"Rush-Presbyterian in Chicago. Ex-Navy, having served in Vietnam. Moved from internal medicine to emergency medicine in '72, which means he must have been one of the first at Rush-Pres, given Cook County had only started a few years before that."
"Sounds like a good guy. I know you wanted Doctor Gibbs."
"I did, but that lowlife who shot up the ED put paid to that, at least in the near term."
We greeted others who had arrived and sat down.
"No Sophia?" Fran asked Robby, who was alone.
"On shift," he replied. "Thankfully, her final OB/GYN rotation has banker's hours!"
We all laughed because that wasn't actually true, though she would end her day at 4:00pm.
Jocelyn and Gene came in and sat down, and I saw something on her face that quickly revealed itself.
"We have a baby!" she exclaimed.
"Congratulations!" several of us exclaimed.
"When?" I asked.
"The day after she delivers, which should be by the end of next week. A baby boy who'll be born to a fifteen-year-old girl. She's Lutheran and went through the Lutheran agency in Columbus. They gave her options, and she liked our biographies."
"Clearly, she's mentally challenged," I said with a smirk.
"Watch it, Mik!" Jocelyn said threateningly.
"Ignore him!" Clarissa exclaimed. "Do you get to name him?"
"Yes. We eliminated 'Michael' for what I think are obvious reasons!"
I stuck my tongue out at Jocelyn, something I hadn't done in at least fifteen years. She laughed and shook her head.
"The MD behaving like a toddler!" she exclaimed.
"I reserve the right to revert to our first days of friendship!" I said with a grin.
"Kindergarten!"
"Yep!"
"You're such a goofball, Mik!"
"You know I'm very happy for you. What names?"
"We've narrowed it down to Timothy or Sean."
"Do you have all the things you'll need?" Serafima asked.
"No, but we have a week to get them," Gene said.
"We'll have a baby shower for you," Clarissa said. "Kris, will you help organize?"
"Yes, of course!" Kris exclaimed.
"I'll help, too!" Tasha interjected. "I'm so happy for you both!"
The adoption was the topic of conversation for basically the entire meal. When we finished eating, we all went to the theatre to see the movie, which I enjoyed. It wasn't quite as good as the book, and it was a stretch to see Sean Connery with a Scots accent playing a Lithuanian Soviet submarine commander, but I enjoyed it. The others had similar reactions, including Kris, though she hadn't read the book.
"Some suspension of disbelief is necessary for movies like that," she said as we walked to my Mustang. "But overall, it was entertaining. You have the book, right?"
"Yes. It's on the shelf in my study. It's part of a series of spy dramas, though it started out as a standalone book. There are three other books in the series now — Patriot Games, The Cardinal of the Kremlin, and Clear and Present Danger. He also wrote a World War III alternate history titled Red Storm Rising."
"Have you read any of them?"
"I have The Cardinal of the Kremlin on my bookshelf, but I haven't had the time to read it. Maybe I'll read it during my vacation. Hopefully, Charlotte Michelle will coöperate and be born during my vacation time, but babies are so unpredictable. I have a tiny amount of flexibility, but if our new daughter doesn't coöperate, we'll have to do some juggling."
"Fortunately, school will be out, so my sister will be able to help."
"For a definition of 'help', which means being a troublemaker!"
"Only to you!"
"In all seriousness, she's a big help and a good aunt. And, as I mentioned, she's found a new victim to torture!"
Kris laughed softly, "Did I torture you?"
"No, but you're not Lyuda!"
"But you got the best sister, right?"
"I absolutely did, Lyuda's claims to the contrary notwithstanding!"
"Do you know how many children Jocelyn and Gene want to adopt?"
"At least two," I replied. "They were fortunate to get an infant so quickly. It could be years before another baby is available for them, though they're willing to adopt a toddler. I appreciate you being willing to help Clarissa plan the baby shower."
"I'd say it was because Jocelyn was the person who knew every dark secret about you growing up, but you don't have any!"
"Neither does she! Nor Dale, either. We were all 'goody-two-shoes' growing up. The most trouble I got into was using a vulgar Russian phrase. I was trying to explain it to Dale, but Mom did not care."
"I think putting soap in a child's mouth is child abuse."
"I would never do it, but it certainly did work. As they say, times were different. It's a logical fallacy to hold people in the past to modern standards of which they were not aware, and likely could not have conceived. Most significant change comes about via small groups of radical thinkers. That was true in France, just as it was here and in England. It took time for the ideas of «Liberté, égalité, fraternité» or the ideas expressed by...
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.
... to be realized, even in a limited fashion. I'd say both countries are still working on it. And I believe you agree, though our proposed solutions are different."
"Says the government doctor, working for a government hospital, treating many patients covered by government health insurance!"
"By choice, «ma chérie»!" ("Sweetheart")
"And our children will attend public school, just as you did, and likely a public university, just as you did..."
"Yes, yes," I chuckled. "I'm OK with social democracy, not with socialism. They are different, the opinions of many of our countrymen to the contrary notwithstanding!"
"You know I like to tease you about it!"
"The story of my life with every woman I know, starting with my mom!"
"And you love all of us!"
"I do."
March 19, 1990, McKinley, Ohio
"What's bugging you?" Carl Strong asked as we ate lunch together early on Monday afternoon.
"What gives you the idea something is bugging me?"
"Just the way you're discussing your training. Even the black swan events of a PGY1 performing surgical procedures in an OR don't seem to have you as up as I would have expected."
"I'm not depressed, if that's your concern."
"No, but if you went there..."
"My mom played those rhetorical games with me from the time I was little. I'm an expert!"
Carl laughed, "OK, but you know that is a major concern for physicians."
"It is, but I think it's more that what I'm doing now doesn't provide the hits of adrenaline and dopamine that working in the ED did. There's too much routine work, if you will."
"You aren't the first emergency medicine specialist to go through dopamine withdrawal! I don't mean this in a perverse way, but you derive pleasure by working at your maximum, and the more, the better. I recall you were never as enthusiastic about slower-paced medicine despite the fact that slower-paced medicine fed your other need — patient interaction. I think we know which drive is stronger."
"I'd say obviously, but it wasn't obvious until I spent eight months in the ED."
"What does your training regimen look like for PGY2?"
"At least the first three months will be better because I'll be in the ED full-time to train Mary Anderson on procedures. After that, I'll alternate one week in the ED and one on a regular surgical team. That will be much better, as it fulfills both my need for dopamine and my need to train."
"Shelly is back on April 1st, right? So you'll go back to the ED?"
"Most likely, yes, but there are other considerations. I'm not sure how the contracts for the locum tenentes in Medicine work."
"Only YOU would decline Latin phrases we use in English!" Doctor Strong said, shaking his head.
"I gotta be me!" I chuckled.
"I believe those contracts are almost always week-to-week, or at most for a month. You should ask Tim Baker, or maybe have Owen Roth ask Baker."
"Clarissa would be VERY happy if she went back to Medicine. She's not an adrenaline or dopamine junkie!"
"Because in our roles, if the adrenaline hits, it's because something has gone terribly wrong. The same is true for all the pure surgeons. For you, it's part of your job, and you can't wait for the next fix!"
"I'm not going to argue with you on that one! How are things going in Cardiology?"
"The beat goes on!" Carl said.
I groaned, "That was bad."
"You have no room to talk!"
"True," I agreed.
"How are you doing with regard to the incident?" Carl asked.
"Fine. I honestly don't think about it except in relation to Loretta. I saw her on Sunday, and she's making slow progress. If I had to guess, six to eight months, though she can probably go home at the end of April."
"She's walking, right?"
"Yes, between the parallel bars with leg braces. Her coördination is slowly coming back, along with muscle tone, but she still has numbness in parts of both extremities that might be permanent."
"We just don't have the knowledge or tech to fix that completely. Where's Oscar Goldman when you need him?"
"He was the money man! You need Doctor Rudy Wells!"
"Sorry if I'm not up on my 70s TV trivia!" Carl declared with a grin.
"Those science fiction shows were my mainstay — Six Million Dollar Man, The Bionic Woman, Logan's Run, Battlestar Galactica, Space: 1999, and reruns of Star Trek. Of course, I also watched Emergency and Medical Center."
"I was more into the cop shows like Adam 12, Dragnet, SWAT, Baretta, and Starsky & Hutch."
"I never asked, but what brought you to medicine?"
"A college professor. I had enrolled in a chemical engineering program. During my first year, my advisor more or less talked me into a biochemistry program instead, on the theory that that was the future. When the time came to look into a Master's, he suggested I also apply to medical school. I took both the GRE and MCAT, applied to both programs, and, in the end, decided on medical school because it was the greater challenge."
"Why cardiology?"
"The first time I actually saw an EKG, besides on television, I was fascinated. From TV, you don't get a true impression of just how much information is available. On TV, it's basically the 'machine that goes ping'."
"That was during your Third Year, right?"
"Yes. There were no Preceptorships at my medical school. They only started here the year before you started."
"You know my theory on that."
Carl nodded, "And there are a number of us who agree; unfortunately, the powers that be at the AMA think requiring an undergraduate degree is sacrosanct and won't even consider radical ideas like six-year medical schools straight out of High School."
"So radical that much of Europe operates that way."
"Socialism!" Carl said with a grin.
"Oh, give me a fracking break!" I chuckled. "I know socialism, and that is NOT socialism!"
"No kidding!"
"My wife teases me about working for a government hospital, which she correctly deduces plenty of our fellow citizens consider 'socialist'. But that's only because they have no clue what that word actually means."
"Nobody ever went broke underestimating the intelligence of the American people."
"HL Mencken was not wrong," I replied. "As my friend Melody, who's now an attorney, said — we know how clueless the average person is; well, statistically speaking, half the people are more clueless than that."
Carl laughed, "I'm going to have to use that! Anyway, I believe our time is up, and we need to get back to our respective services."
He was correct, so we left the cafeteria and took the stairs up one floor, where he turned right, and I turned left. I went straight to Owen Roth's office and was happy to see him.
"Time for a quick question?" I inquired.
"If it's really quick," he said. "What?"
"I wondered if you knew if the locum tenentes contracts were until the end of May?"
"Pedantic to a fault," Doctor Roth declared. "Every other person would just say locums or locum tenenses!"
"I'd say 'sorry', but I'm positive you know I wouldn't mean it."
"Correct. They're on contract until the end of March, then week to week. Let me guess, you want to be released from your bondage and go back to the ED."
"I'd love to, and Doctor Saunders would be ecstatic to go back to Medicine."
"Did she put you up to this?"
"Only in the sense of bitching about not signing up for the chaos and insanity that can be the ED."
"Let me speak to Tim Baker. Shelly is a hundred percent in my mind, so we'll be back to full staff. I'm OK with you going back to your natural habitat. I'm positive Baker will be receptive, as it'll save him some money, and that's our scarcest resource."
"Thanks."
"By the way, I assume you're happy that the players and owners reached an agreement to end the baseball lockout."
"I absolutely am. I was worried about the season, but it looks like they'll just push it back a week or so."
"I think the Reds have a good shot," Carl said.
"I hope so!"
"Talk to you later."
"Yes."
I left his office and went to find my students to supervise our afternoon procedure.
March 20, 1990, McKinley, Ohio
"I'd kiss you if it wouldn't get me in trouble with your French girl!" Clarissa exclaimed. "A hug will have to do!"
We hugged.
"Did they mention what I consider the one downside?" I asked.
"That I'll still cover the Free Clinic? Yes. I know you really enjoy that, but it's PGY1s only, so it was going to end anyway. You could always volunteer."
"Eventually. Fortunately, I get to keep my current schedule, which is 0500 to 1700 Monday through Friday."
"Who picks up the extra hours?"
"Other ED staff," I replied. "I'm on call for emergency surgery or disaster protocols."
"Pager duty?"
"Until the end of May. After that, I'll be on the usual rotation of PGY2s for pager duty once every four weeks. Because of my dual specialty, I'll be the first one called in for a disaster protocol, no matter who has the duty pager."
"You'll carry a pager full-time?"
"Yes."
"Better you than me!" Clarissa declared.
I chuckled, "Your name is on the disaster protocol list right below mine."
"What god did I piss off? I was supposed to be in medicine with time to care for my patients, not work in pit lane at a NASCAR race!"
"Poor baby," I replied. "There have only been two protocols in the last four years."
"Oh, sure! Jinx it!"
I laughed, "You have two more weeks in captivity, then you're free to go back to routine medicine."
"I like routine medicine!"
"It takes all kinds, I guess!" I grinned.
"Go back to your ward, Petrovich! But thanks for the good news! Lunch?"
"If we can swing it, yes."
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